ⅠC期卵巢癌新手术病理分期合理性的分析

The Rationality of the New Staging System for Ovarian Carcinoma StageⅠC

[目的]观察卵巢癌FIGO 2013新分期ⅠC期标准变化的合理性。[方法]选取113例ⅠC期卵巢癌病例,整理分析其术后病理资料和随访资料。将113例患者根据其病历资料按FIGO 2013新分期标准重新进行亚分期,分为ⅠC1、ⅠC2和ⅠC3期。从5年生存率及多因素分析两方面比较ⅠC期卵巢癌新分期变化的合理性。[结果]FIGO 1988年分期中ⅠC期卵巢癌5年生存率为82.4%;FIGO 2013年新分期中ⅠC1、ⅠC2和ⅠC3各亚期的5年生存率分别为92.1%、83.9%、79.5%,新分期各期的5年生存率差异无统计学意义（χ~2=2.881,P=0.237）。对肿瘤分期、年龄、初潮年龄、是否绝经、生育次数、病理学类型和组织学分级对预后的影响进行Cox回归分析,肿瘤分期、年龄、初潮年龄、是否绝经、生育次数、病理学类型并非影响预后的危险因素（P〉0.05）;而组织学分级是ⅠC期卵巢癌预后的危险因素（OR=1.474,P=0.001）。[结论]新分期将ⅠC期卵巢癌分为各亚期后其5年生存率无明显差异;ⅠC亚分期并不是影响卵巢癌预后的独立因素,组织学分级是卵巢癌预后的危险因素。因此FIGO2013将ⅠC期卵巢癌为ⅠC1、ⅠC2、ⅠC3亚期,似乎并不能更好地评估预后。

[Objective] To evaluate the rationality of the reassignment of International Federation of Gynecology and Obstetrics（FIGO） 2013 staging system for ovarian carcinoma stage Ⅰ C.[Methods] The clinical data in 113 patients with ovarian carcinoma stageⅠC were collected and sorted. Patients were categorized into stage ⅠC1, ⅠC2 and ⅠC3 according to FIGO 2013 staging system for ovarian carcinoma. The rationality of the substage was assessed through the 5-year survival rate estimated by Kaplan-Meier method and the multivariate analysis. [Results] The 5-year survival rate of stage ⅠC of FIGO 1988 staging system was 82.4%;and the 5-year survival rate of stage ⅠC1,ⅠC2 and ⅠC3 were 92.1%,83.9% and 79.5%,and the comparison of 5-year survival rate among these substages didn＇t show significant difference（χ~2=2.881,P=0.237）.The Cox regression analysis model was used to analyze the influence of the operative pathological stage,age,age of menarche,menopause status,birth frequency,pathological type and histological grade on the prognosis. The operative pathological stage,age,age of menarche,menopause status,birth frequency,pathological type were not the risk factors for the prognosis of ovarian carcinoma stageⅠC（P0.05）. Histological grade was an independent risk factor for the prognosis of ovarian carcinoma stageⅠC（OR=1.474,P=0.001）. [Conclusion] There is no significant difference in the 5-year survival rate among the substages in the FIGO 2013 system for ovarian carcinoma stage ⅠC. The substage is not an independent factor for predicting the prognosis,but the histological grade is. It seems unreasonable in the FIGO 2013 system about the division of stage ⅠC ovarian carcinoma into stage ⅠC1,ⅠC2 and ⅠC3.